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[The influence of an ECG on patient management in family practice]
M J van Dijke1, W N van den Berg, A W Hoes
1Vakgroep Huisartgeneeskunde, Universiteit Utrecht.
Objective:
To determine how often electrocardiography, as an addition to history taking and physical examination, leads to changes in non-emergency patient management in general practice.
Design:
Prospective observational study.
Setting:
18 general practices in Amersfoort and its surroundings, the Netherlands.
Method:
From the end of September, 1996 until the beginning of February 1997, the general practitioners (GPs) filled out two questionnaires each time an ECG was recorded, one before and one after the recording. The patient management planned by the GP before and after the availability of the ECG results was then compared.
Results:
A total of 119 sets of questionnaires was obtained from 119 patients. In 47 patients (40%; 95% confidence interval: 31-48) the GP's management changed after recording and interpretation of the electrocardiogram. In particular, the decision whether or not to refer patients to a cardiologist was frequently changed (26 patients, 22%). The GPs management changed more often in patients in whom palpitations and dyspnoea had been the reason for taking an ECG.
Conclusion:
The use of electrocardiography in general practice in non-emergency situations would seem a valuable instrument in addition to history taking and physical examination.